Thursday, April 17, 2014
By Steve Mistler firstname.lastname@example.org
State House Bureau
The past two Legislatures have reviewed – and defeated – proposals to make the board meetings of the state's hospitals subject to Maine's right-to-know law. This year the state's top lawyer is upping the ante with a bill that would require some hospitals that receive public funding to hold public meetings.
State Attorney General Janet Mills
Staff photo by Andy Molloy
Attorney General Janet Mills said Monday that she's drafting legislation that would affect hospitals that receive 50 percent or more of their operating revenues from state and federal funding.
The measure would allow the public to attend board deliberations at those hospitals on issues such as capital expansion projects and purchases that could affect host communities and taxpayers.
Mills' bill, which has not yet been printed, arrives as state lawmakers and Gov. Paul LePage prepare for deliberations on the budget and the governor's proposal to pay $484 million in Medicaid and Medicare reimbursements owed to hospitals by the state.
The debt payoff plan is politically charged. Democratic lawmakers agree that the state should reimburse the hospitals, but they are uneasy about the governor's apparent coziness with the Maine Hospital Association, the influential organization representing the state's 39 hospitals, 34 of which are nonprofits.
Mills, a Democrat, said Monday that her proposal isn't politically motivated. She said hospitals that receive significant public funding should conduct business that affects their host communities in the light of day.
"They make decisions every month that affect our communities and affect our state," Mills said. "They make decisions about whether to build large buildings. They make decisions about whether to take our tax dollars and buy large pieces of equipment. Some of those decisions are reviewed by public entities, some are not.
"The decisions affect thousands of employees and hundreds if not thousands of businesses who receive services from these hospitals and who negotiate with hospitals," Mills said.
According to statistics from the Maine Department of Labor, 11 hospitals are among the state's top 30 employers and four are in the top 10.
Previous proposals to include hospitals in the state's Freedom of Access Act have failed amid opposition from the Maine Hospital Association. These include a 2011 bill by Rep. Adam Goode, D-Bangor, that would have originally subjected hospitals receiving $250,000 in state or federal funds to the state's open-records law. That measure would have affected all of Maine's hospitals.
Goode later proposed raising the public funding threshold to $1 million and simply making board meetings public. The bill was unanimously rejected by the Legislature's Health and Human Services Committee.
The committee based part of its decision on a 2008 opinion by the state's Right to Know Advisory Committee. The panel, which reviews changes to the open-records law, worried that the bill would eventually affect all nonprofits, which are essentially private entities. According to committee minutes, some members believed that a proposal could be tailored to nonprofits that "perform a public function" -- such as hospitals -- but no proposal emerged.
Mills said her proposal will only target hospitals. She said the open-records requirement would not apply to proprietary, personnel or patient information. Such matters, she said, could be discussed in private session, just as public entities do now.
It's not yet clear how many hospitals would be affected under her proposed funding trigger.
Most hospitals receive federal and state funds through Medicaid and Medicare reimbursement. The reimbursement is also the source of Maine's current debt to hospitals.
In 2011, the hospital association described Goode's bill as a "slap-back proposal" -- retribution against its members for publicly challenging lawmakers to settle the state's debt.
Jeffrey Austin, a lobbyist for the hospital association, declined to characterize Mills' proposal without first discussing it with her. However, he said, his group would likely oppose a bill that treats hospitals differently than other private entities.
"We don't know of any reason why hospitals shouldn't be afforded the same status as other private businesses," he said. "I'm not aware of any other private businesses that have their meetings open by state law. Certainly people are interested in hospitals, but they're also interested in other businesses as well. I'm not sure why we're being singled out."
Mills said she hoped to work with the hospital association to craft the bill. She said the state's open-records law has increased accountability to the public, which helps pay the bills.
"It would behoove these communities, private agencies and the hospitals themselves to open the door just a crack and allow public access to the board meetings," Mills said. "Frankly, the Freedom of Access Act has been on the books for more than 50 years now. County governments, municipal governments and government entities with much smaller budgets have contended with the ins and outs of public meeting laws for many years, for decades."
According to data compiled by the National Freedom of Information Coalition, many state "sunshine laws" exempt hospitals, but others, such as Florida and West Virginia, force some hospitals receiving public funding to hold open meetings.
Connecticut's sunshine law has a provision that includes private organizations that receive a certain portion of public funding. Other New England states are silent on the issue.
Mills has not begun courting lawmakers to sponsor her bill. She must do so by the end of the month.
Steve Mistler can be contacted at 620-7016 or at: